To investigate the current management status of chronic kidney disease (CKD) in the Tibet region and explore the disparities in diagnosis, treatment, and education among hospitals of different levels and healthcare professionals, so as to provide a basis for formulating prevention and control strategies and standardized management for CKD in high-altitude and alpine regions.

A cross-sectional questionnaire-based survey was conducted among healthcare professionals from the Tibet region who participated in CKD standardized training for primary care physicians in September 2025. The survey covered CKD screening, current status of diagnosis, treatment and management, nursing care, and patient education, as well as the training needs of professionals. Disparities in diagnosis, treatment, and management of CKD between hospitals of different levels and between nephrology and non-nephrology staff were compared.

A total of 54 valid questionnaires were collected. The average altitude of the hospitals where the respondents worked was 3, 650 meters. Of the respondents, 79.6% were from tertiary hospitals, and 68.5% were engaged in nephrology practice. The availability of routine CKD-related tests (complete blood count, blood glucose, blood lipids, serum creatinine, and urinalysis) in hospitals of the Tibet region exceeded 90%, while the availability of the urine microalbumin-to-creatinine ratio (UACR) test was 74.1%. Tertiary hospitals demonstrated superior capability in detecting UACR (χ²=10.864, P<0.01), ferritin (χ²=6.642, P=0.01), and erythropoietin (χ²=5.130, P=0.024) compared to primary care institutions (including secondary and primary hospitals). Calcium channel blockers were the most frequently used antihypertensive agents for renal hypertension (37.4%), followed by renin-angiotensin-aldosterone system inhibitors (29.6%). Regarding anemia management, 31.5% of respondents reported difficulties in diagnosing "true" anemia in high-altitude regions. Nephrologists demonstrated more experience in using intravenous iron (χ²=4.598, P=0.032), erythropoiesis-stimulating agents (χ²=11.977, P<0.01), and hypoxia-inducible factor prolyl hydroxylase inhibitors (χ²=12.362, P<0.01) compared to non-nephrology staff. Deficiencies were observed in patient education. Only 38.9% of healthcare workers were able to provide systematic education, while 51.5% offered verbal guidance. Nursing practice was mainly constrained by a lack of skills training (37.0%) and insufficient manpower (35.2%). In terms of multidisciplinary collaboration, 66.1% of the hospitals had access to online or offline consultation channels. The training needs of healthcare professionals focused primarily on guideline interpretation (75.9%), nutritional management (72.2%), and the standardized management of CKD complications (68.5%).

In the Tibet region, primary care institutions demonstrated relatively limited detection capabilities in CKD management compared to tertiary hospitals. Furthermore, continuing education and nursing resource allocation in local healthcare facilities require further strengthening or optimization.